Avoiding The Side Stitch

Avoiding The Side Stitch

A side stitch can be one of the most frustrating experiences during a race, leaving us feeling bewildered as to the cause and helpless to find a quick solution.  Let’s find out more about the reasons behind getting a stitch and what we can do to prevent and fix it.


Nobody is 100% sure on this, but the general consensus is that it relates to limited blood and oxygen supply to the diaphragm, which causes a cramping sensation (the sharp pain you feel below your ribs).

When we run, we put stress on our internal organs every time our foot strikes the ground and our diaphragm also moves every time we breath in and out (which follows the rhythmic pattern of our cadence).  This therefore creates tension when we run and can result in cramps in our diaphragm (a side stitch).

Other factors which are believed to be linked to the cause of a side stitch are:

  • shallow breathing;
  • poor running posture;
  • insufficient warm up before hard running;
  • weak core; and
  • bloated stomach.

Luckily, all of the above have means of prevention (see below).  Those of us who are mentally strong enough to ride out the pain of a side stitch need not be debilitated by it, but for the majority, the discomfort is just too severe and we are forced to slow down or stop, which obviously is a major issue if we are trying to run a strong race and hit a target time.

But stitches are harmless and they will pass with time, so try to grit your teeth and maintain your pace until it goes.  Here are some tips for preventing and curing a side stitch.


  • Ensure you do not eat too much before running. Having a bloated stomach will increase your chances of getting a stitch.
  • Avoid eating anything within 2-3 hours of your race start time. Experiment with this however, to test what works for you, as it may be that you are able to process an energy snack during this time window without issue.  Everybody’s digestive systems are different and you must find what works for you.
  • Pace yourself carefully and don’t go off too fast too soon!
  • Ensure to include abdominal (core) exercises within your regular training routine. This will help you maintain a good running posture and minimises movement in the upper body which may provide less support to your internal organs.
  • Practice your breathing patterns during your training, to ensure you are not taking shallow breaths, and to ensure you can mix up your breathing rhythm during a race.
  • Conduct a proper warm up before any race distance, including dynamic stretching, light jogging and fast strides. A pre-race warm up should have the same intensity as you preform for any quality training session involving hard running.


  • Exhale in an exaggerated fashion on each foot strike to try and disturb the bubble of trapped air that may be putting pressure on your diaphragm and causing the pain that we associate with a side stitch. Do this on both sides (left and right foot strike) and continue it until the stitch goes away.
  • Stick 2 fingers under your ribcage while breathing out slowly and deeply (to try and dislodge the pocket of air).
  • Slow down your pace or walk for a short period. For many of us this is the only option, but experienced runners should be able to get rid of a stitch without radically altering their pace.

Dealing with a side stitch is something that you need to practice during your training.  Even the strongest and fastest runners are prone to side stitches, just that they probably hide it better and don’t let it slow their pace!


By Jeffrey Ross, Director of The Running Plan, www.therunningplan.com

Share This